Pre-eclampsia, (Pregnancy with Hypertension And Proteinuria) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Pre-eclampsia, Diagnosis and Treatment and Related Diseases
Recently we had a few cases of pregnant mothers with pre-eclampsia losing their fetuses.
It is heart breaking especially if the mother is having her first pregnancy and the fetus is fairly advanced.
It is therefore important for a pregnant mother to know about pre-eclampsia.

Pre-eclampsia is when a pregnant woman forms high blood pressure and protein in the urine after the 20th week of pregnancy.
Pre-eclampsia is described as pregnancy-induced hypertension together with proteinuria (>0.3 g in 24 hours) with or without edema.
Almost any organ system may be affected.
Pre-eclampsia is a fairly frequent disorder that may become life-threatening for the mother and the fetus.
It is featured by maternal hypertension, proteinuria, edema, fetal intrauterine growth limitation and premature birth.
Severe pre-eclampsia is defined as diastolic blood pressure (BP) of at least 110 mm Hg or systolic BP of at least 160 mm Hg, and symptoms, and biochemical and hematological damage.
In severe pre-eclampsia, the fetus and newborn may have neurological injury caused by hypoxia.
Prompt detection of pre-eclampsia and signs of medical damage, such as any decrease in platelet count, needs urgent referral to hospital to prevent the serious medical effects of these disorders.
Eclampsia is described as the episode of one or more convulsions superimposed on pre-eclampsia.
Causes
The precise cause of pre-eclampsia is not known.
It is featured by suboptimal utero-placental perfusion linked with a maternal inflammatory response and poor maternal vascular endothelial function.
This in turn results in vascular hyper-permeability, thrombophilia and hypertension, which may balance the reduced flow in the uterine arteries.
A protective part of heme oxygenase 1 and its metabolite carbon monoxide may be affected.
The placenta has a pivotal part in the formation of pre-eclampsia.
It happens in about 3% to 7% of all pregnancies from:
1.Autoimmune disorders
2.Blood vessel problems
3.The diet
4.The genes
Symptoms
Often, women who have pre-eclampsia do not feel ill.
Pre-eclampsia is defined by systolic BP >140 mm Hg or diastolic BP >90 mm Hg in the second half of pregnancy, with ≥1+ proteinuria on reagent stick testing:
Diagnosis:
1.High blood pressure, often higher than 140/90 mm/Hg
2.Swelling in the hands and face
3.Weight gain
4.Protein in the urine (proteinuria)
5.Higher-than-normal liver enzymes
6.Platelet count that is low
7.Ultrasound assessment of fetal growth and the volume of amniotic fluid
Treatment:
The only way to cure pre-eclampsia is to deliver the baby.
1.Bed rest, and lying on the left side
2.Drinking plenty of water
3.Eating less salt
Hospital:
1.Close monitoring of the mother and baby
2.Medicines to control blood pressure and seizures
3.Steroid injections for pregnancies under 34 weeks
The baby must be delivered if there are signs of severe pre-eclampsia:
1.Tests that show the baby is not growing well or is not getting enough blood and oxygen
2.The bottom number of the blood pressure is over 110 mmHg
3.Abnormal liver function
4.Seizures or alterations in mental function (eclampsia)
5.Fluid buildup in the mother's lungs
6.HELLP syndrome
7.Low platelet count
8.Low urine output
High blood pressure:
1.Labetalol
2.Nefidipine
3.Hydralazine
Seizures:
Magnesium sulfate to control seizures
Fluid balance:
Fluid restriction
Delivery:
The decision to deliver should be made once the woman is stable
If the fetus is less than 34 weeks, steroids are given
Vaginal delivery is suggested after 37 weeks but caesarean section tends more likely
Postpartum review of BP and mother and baby is needed.
TABLE OF CONTENT
Introductio

• Language: English
• Publisher: Kenneth Kee
• Release date: Jun 6, 2018
• ISBN: 9780463533888

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Pre-eclampsia,

(Pregnancy with Hypertension

And Proteinuria)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2018 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Pre-eclampsia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Pre-eclampsia)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Pre-eclampsia (High Blood Pressure and Proteinuria during Pregnancy)

Recently we had a few cases of pregnant mothers with pre-eclampsia losing their fetuses.

It is heart breaking especially if the mother is having her first pregnancy and the fetus is fairly advanced.

It is therefore important for a pregnant mother to know about pre-eclampsia.

What is Pre-eclampsia?

Pre-eclampsia is when a pregnant woman forms high blood pressure and protein in the urine after the 20th week of pregnancy.

Pre-eclampsia is described as pregnancy-induced hypertension together with proteinuria (>0.3 g in 24 hours) with or without edema.

Almost any organ system may be affected.

Pre-eclampsia is a fairly frequent disorder that may become life-threatening for the mother and the fetus.

It is featured by maternal hypertension, proteinuria, edema, fetal intrauterine growth limitation and premature birth.

Severe pre-eclampsia is defined as diastolic blood pressure (BP) of at least 110 mm Hg or systolic BP of at least 160 mm Hg, and symptoms, and biochemical and hematological damage.

In severe pre-eclampsia, the fetus and newborn may have neurological injury caused by hypoxia.

Prompt detection of pre-eclampsia and signs of medical damage, such as any decrease in platelet count, needs urgent referral to hospital to prevent the serious medical effects of these disorders.

Eclampsia is described as the episode of one or more convulsions superimposed on pre-eclampsia.

Incidence

Severe pre-eclampsia and eclampsia are fairly infrequent but serious complications of pregnancy.

They are the second main cause of direct maternal deaths.

The incidence of severe pre-eclampsia is about 5/1,000 maternities.

The incidence of eclampsia is about 5/10,000 pregnancies.

44% of seizures happen post-natally, the remaining being ante-partum (38%) or intra-partum (18%).

The deaths from eclampsia and pre-eclampsia are presently at their lowest ever documented rate

This is a rate of 0.38 per 100,000 maternities (95% C.I. 0.18 - 0.71)

20% of neonatal stillbirths where there was no congenital anomaly happened in women with pre-eclampsia

What are the causes of Pre-eclampsia?

Causes

The precise cause of pre-eclampsia is not known.

The pathogenesis of pre-eclampsia is still not well understood.

It is featured by suboptimal utero-placental perfusion linked with a maternal inflammatory response and poor maternal vascular endothelial function.

This in turn results in vascular hyper-permeability, thrombophilia and hypertension, which may balance the reduced flow in the uterine arteries.

A protective part of heme oxygenase 1 and its metabolite carbon monoxide may be affected.

It is shown that pre-eclampsia is less frequent in smokers.

The placenta has a pivotal part in the formation of pre-eclampsia.

It happens in about 3% to 7% of all pregnancies from:

1. Autoimmune disorders

2. Blood vessel problems

3. The diet

4. The genes

Risk factors are:

1. First pregnancy

2. Past history of pre-eclampsia

3. Multiple pregnancy (twins or more)

4. Family history of pre-eclampsia

5. Obesity

6. Being older than age 35

7. History of diabetes, high blood pressure, or kidney disease

Pre-eclampsia and eclampsia also result substantially to the numbers of infants born preterm; 50% of women with severe pre-eclampsia